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ADEC - VILLAGE WOMEN

Residential Treatment Facilities Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities

Provider NPI: 1710101183

Organization Information:
Organization Name:  ADEC - VILLAGE WOMEN
Authorized Official:  PAULA M SHIVELY  CEO  574-848-7451

Practice Location:
807 MOTTVILLE RD  BRISTOL, IN 46507-9220 US
Tel: 574-848-7451  Fax: 574-848-5917

Business Mailing Address:
19670 SR 120  BRISTOL, IN 46507-0398 US
Tel: 574-848-7451  Fax: 574-848-5917

NPI Information:
NPI: 1710101183
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y320600000XResidential Treatment Facilities
Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities
IN2670I0003JN06

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 320600000X

Type:

Classification:



Definition:



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